Obstructive lung diseases

Question 1

bronchiectasis

Answer 1

irreversible dilatation of small and medium sized bronchi due to chronic inflammation and infection

Question 2

bronchiectasis: causes

Answer 2

post-infective: tuberculosis, measles, pertussis, pneumonia
cystic fibrosis
bronchial obstruction e.g. lung cancer/foreign body
immune deficiency: selective IgA, hypogammaglobulinaemia
allergic bronchopulmonary aspergillosis (ABPA)
ciliary dyskinetic syndromes: Kartagener’s syndrome, Young’s syndrome
yellow nail syndrome

Question 3

Most common organisms isolated from patients with bronchiectasis:

Answer 3

Haemophilus influenzae (most common)
Pseudomonas aeruginosa
Klebsiella spp.
Streptococcus pneumoniae

Question 4

bronchiectasis: Mgmt

Answer 4

physical training (e.g. inspiratory muscle training) - has a good evidence base for patients with non-cystic fibrosis bronchiectasis
postural drainage
antibiotics for exacerbations + long-term rotating antibiotics in severe cases
bronchodilators in selected cases
immunisations
surgery in selected cases (e.g. Localised disease)

Question 5

bronchiectasis: main features

Answer 5

-chronic persistent cough
-copious purulent thick mucus
-chest pain
-SOB
-hemoptysis in 1/3
-weight loss
-plethora
-recurrent chest infection
-clubbing

Question 6

bronchiectasis: clinical findings

Answer 6

-dullness to percussion
-crackles/wheezes/rhonchi
-inspiratory squeaky sounds
-bronchial breath sounds

Question 7

bronchiectasis: CXR findings

Answer 7

may be normal
tramline cysts or ring opacities

Question 8

bronchiectasis: CT findings

Answer 8

tram-track appearance
signet ring sign

Question 9

bronchiectasis: gold standard investigation

Answer 9

HRCT

Question 10

bronchiectasis: